Atazanavir / ritonavir

Lamotrigine

Dosage adjustment may be necessary.

No pharmaceutical opinion available for this interaction.

Mechanism

Atazanavir / ritonavir can induce the metabolism (UGT 1A4) and decrease the concentration of Lamotrigine.

Atazanavir / ritonavir

Pharmacodynamic effects

Recommendations

Alternative solution(s)

Lamotrigine

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

An increase in dosage may be necessary.

Monitor for signs and symptoms of therapeutic failure.

Alternative solution(s)

Monitor

Tests

Lamotrigine

Pharmacokinetic parameters
Parameters
Reference number
# patients
HIV
Dose
Frequency
AUC
Cmax
Lamotrigine
2221
17
-
100 mg
x 1
- 32%
- 6%
Atazanavir / ritonavir
2221
17
-
300/100 mg
QD
 
 
Comment

A lamotrigine dose of 200 mg BID with PI produces a concentration similar to lamotrigine 100 mg BID used alone.

See also lopinavir/ritonavir + lamotrigine.

Reference
  • 122
    Ritonavir (Norvir), Corporation AbbVie, Quebec, Canada, 5 juillet 2021.
  • 2111
    Van der Lee MJ, Dawood L, ter Hofstede H, et al. Lopinavir/ritonavir reduces lamotrigine plasma concentrations in healthy subjects. Clin Pharmacol Ther 2006; 80:159-168.
  • 2219
    Sandson N. An overview of Psychotropic Drug-Drug Interactions. Psychosomatics 2005;46(5) : 464-489.
  • 2221
    Burger D, Huisman A, Van Ewijk N, Neisingh H, Van Uden P, Rongen G, Koopmans P, Bertz R. The Effect of Atazanavir and Atazanavir/Ritonavir on UDP-Glucuronosyltransferase Using Lamotrigine as a Phenotypic Probe. Clin Pharmacol Ther. 2008.
  • 1382
    Atazanavir (Reyataz), Bristol-Myers Squibb, Quebec, Canada, 26 octobre 2018.